Expert: Ronald Levy, M.D. - 4/13/2011

Question
My husband underwent surgery on 5-16-2010 to repair a crushed bone in his wrist due to a fall from a ladder.  He is 44 and hated everything about the whole unfortunate situation.  Everything about it from the er, to the doctors to the repeated questioning in the er.  He hates being confined, does not go for any type of doating, does not deal well with pain and does not like doctors, so you can see that the whole situation was bad from the moment we walked into the emergency room.  My concern is that he has had a total personality change.  It was like you flipped a switch and turned the kind gentle todd off and turned the cold, harsh, emotionless todd on.  I have had various talks with him and he just doesn't see the change.  It has gotten to the point that it has harshly affected our 19 year marriage.  We have 4 children and they have also noticed the 360degree change in the father since than.  What do I do and how do I get him to understand that something needs to be done.  I feel he is in some form of depression though he does not see it and was wondering if there was a medicine that might help to get his chemical imbalances balanced.  He will go days without speaking to me at night totally opposite of how he was before the surgery.  Please help as I don't know how to manage this!!!

Answer
This is way outside my area of expertise. You don't mention if he has had any permanent disability or chronic pain since the accident. If yes, this could certainly lead to feelings of depression, etc. If you say your husband was negative towards medicine and doctors before the surgery, then you really have an uphill battle. He would certainly do well to be seen by a psychiatrist (not psychologist) for an evaluation but to convince him to do that may be impossible. Have your friends and his business collegues also noticed the change? There's an old saying "If one person tells you you're sick, you can dismiss it, but if two people tell you, you should probably lie down". If only the family sees it, it will be hard to convince him but if his close friends and collegues also notice the change, maybe hearing it from them might convince him to seek help. I can only tell you this personality change is not a consequence of the anesthesia, there is something else going on.

Ronald Levy, MD
Professor of Anesthesiology
UTMb-Galveston